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Permit No. 19636 BUILDING ADDRESS: 13931 HEARTH STONE LANE PERMIT NUMBER: 19636 BUILDING INFORMATION APPLICANT INFORMATION BUILDING PERMIT APPLICATION Address: 113931 HEARTH STONE LANE Name. IA CUT ABOVE ' Community Development APN• 11024-341-51 Address. 11995 W ESPLANADE 2001 Grand Avenue»° e Lot: 1138 City,Zip Code. 1HEMET,CA 92545 ' _.. . Chino Hills,CA 91709 ;i„'°; Cross Streets ICHINO HILLS PKWY I Phone/Pager 1(800)700-7754 I ext. 1 "TM°`t'"°" LICENSED CONTRACTOR DECLARATION Tract/Parcel 113651 City Bus Lic#: 101-04077 I hereby affirm that I'm licensed under the provisions of Chapter 9(commencing with Section Valuation: 1$200.00 ENGINEER/ARCHITECT INFORMATION 7000 of Division 3 of the Business and Professions Code)and my license is in full force and effect OWNER INFORMATION Name: 1N/A OWNER BUILDER DECLARATION Name DAVID REED Address• I hereby affirm that I'm exempt from the Contractor's License Law for the following reason: Address: 113931 HEARTH STONE LANE City,Zip Code. O I,as the owner of the property,or my employees with wages as their whole City,Zip Code CHINO HILLS,CA 91709 Phone. ext compensation,will do the work,and the structure is not intended or offered for sale. Phone. (909)613-0773 ext Lie 4. 1 6 I,as owner of the property,am exclusively contracting with licensed contractors to Bus Lic#. N/A City Bus Lie#: construct the project. I am exempt under Section I i BPC for this reason I i Bus Exp. 1 APPROVAL INFORMATION WORKERS'COMPENSATION DECLARATION CONTRACTOR INFORMATION Issued By: IYVETTE MARTINEZ I hereby affirm under penalty of perjury one of the following declarations: Contractor: A CUT ABOVE 1 Date Issued• 13/1/02 Address: 11995 W.ESPLANADE I Finance Code C4 I have and will maintain a certificate of consent to self-insure for workers'compensation o as provided by Section 3700 of the Labor Code,for the performance of the work for City,Zip Code. HEMET,CA 92545 Census Code / which this permit is issued. Phone or Pager 1(800)700-7754 ext. 1 I Final Date. 1 31/,.5in 2- r / Bus Lie 4: 01-04077 Final By. %,rL /aJ/ I have and will maintain workers'compensation,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My Lie.#. 1672202 Extension V workers'compensation insurance carrier and policy number are Exp Date 106/03 I Reviewed By INSURANCE INFORMATION L lass• IBI I Approved By Insurance Company STATE FUND 11 f PROJECT INFORMATION Policy Number: 1371336 PROJECT DESCRIPTION LOCATION SQUARE FT. Expiration Date: 11/01/02 Structure. O Section need not be completed if permit is for one hundred dollars($100)or less Garage I I certify that in the performance of the work for which this permit is issued I shall not employ Patio I I I I *any person in any manner so as to become subject to the Workers'Compensation Laws of Porch I California and agree that if I should become subject to the workers'compensation provisions of Other 1GAS AND ELEC (REAR Section 3700 of the Labor Code. I shall comply with those provisions. 'GAS LINE AND ELECTRICAL LINE FOR FUTURE BBQ AND ELECTRICAL LINE FOR SPA PROPOSED USE Date: i i Signature: i i I certify I have read this application and state that the above information is correct I agree to comply with all City Ordinances and state laws and hereby au •4rize representatives of this City to COMMENTS enter upon the above mentioned property for inspection I. ase. A Date: i-2--1 ...0'7 l Signature: ' :'/ r i..‘--4 . I OTHER FEES REQUIRED i ZONING SETBACKS DINGiOR TO ACTUAL PERMIT PERMIT FEE INFORMATION ISSUANCE Zoning PD Front Yard 18 Over X Issuance: 1 $30 00 I Electrical $55 50 Land Use, IFR-1 I Side Yard 5/5 Cut: 1 0 chool i NO I $91.50 Plan Rear Yard. 20 Development NO Plan Check $0 00 Plumbing $6 00 Permit Fees: Fill 0 SMTP $0 00 Occ. ACCESSORY SSY Total 1 0 I Sewer: NO Mechanical 1 $0 00 1 Structural $0 00 Type. TO R3 VN Water: NO . Geo Review: I $0 00 I Grading $0 00 I Total Fee Due $91.50 • INSPECTION RECORD Permit Number ispection Date Inspector Inspection Date Inspector grading: regrade Meeting FINAL INSPECTIONS (Inspector verify following) ,ough Grade NO OCCUPANCY PERMITTED WITHOUT FINAL I erraces County Environmental ,ub Drains Health Dept inish Grading Planning Dept oils Certification Public Works grading Certification Fire Rough Landscape +s Built Approved Inderground Site Inspections: ALL ABOVE MUST BE APPROVED BEFORE FINAL BLDG luilding Sewer Final Grade J.G.Waste Plumbing Final Electric Vater Service Final Plumbing itorm Drain/Catch Basins Final Mechanical /, JIG Conduit/Electrical Final Building/Construction 3/c/02_ kti-,1 >Impaction Report Water Meter Number %BOVE IS REQUIRED PRIOR TO FOUNDATION INSPECTION. ,00tings CERTIFICATE OF OCCUPANCY JFER Ground(Rebar/Copper) lardware/Hold-Downs iers/CaissonsiTendons OTHER: Slab Grade DO NOT POUR CONCRETE UNTIL ABOVE IS APPROVED Shear Roof Nailing Exterior Walls Interior Walls Hardware/Hold-Downs Rough Electric Rough Mechanical Rough Plumbing/Topout Framing COVER NO WORK UNTIL ABOVE IS APPROVED Insulation Drywall Interior/Exterior Lath Stucco Scratch Roof Covering Block Wall Inspections : Footing,ReBar 1st Lift Bond Beam 2nd Lift Bond Beam 3rd Lift Bond Beam Drain/Seal SWIMMING POOLS : Location/Rebar/Bonding/Light Cr Conduit Ro Elect POOL NOT TO BE FILLED UNTIL FENCING IS COMPLETE Fence,Gate&Alarm Final Pool Temp Power Pole Electric Release 0 1 Gas Test 3/02- a/A